Behavioral, Anesthetic, MS, Headache, CNS, Pain pharm - Unit 3 Flashcards
Which DA pathway controls movement (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
nigrastriatal
Which DA pathway controls reward and perception (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
mesolimbic
which DA pathway controls executive function (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
mesocortical
which DA pathway controls pituitary prolactin function (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
tuboinfundibular
hyperfunction of this DA pathway causes addiction + hallucination (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
mesolimbic
hypofuction of this DA pathway causes dyskinesia as in parkinsons (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
nigrostriatal
hypofunction of this DA pathway causes innatention as in ADD (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
mesocortical
hypofunction of this DA pathway causes amotivation, apathy (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
mesolimbic
treating schizophrenia with a DA agonist can cause lactation via this pathway (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular)
tuboinfundibular
What enzyme breaks down dopamine, norepinephrine and epinephrine in the brain?
COMT: catechol-O-methyl transferase
Used to treat parkinsons is the precursor to dopamine (levodopa/ carbidopa/ bupropoin)
levodopa
used to prevent peripheral dopamine activity, lowers fatigue, dizziness and nausea (levodopa/ carbidopa/ bupropoin)
carbidopa
A NEDA reuptake inhibitor, NDRI antidepressant (levodopa/ carbidopa/ bupropoin)
bupropion
What are the 3 stimulant true amphetamines that can block DAT and even drive it backwards:
- dextroamphetamine 2. lisdexamfetamine 3. mixed amphetamine salts
what are the two mild stimulants that increase histamine, used for narcolepsy, apnea and shift-work, not ADHD
- Modafinil 2. Armodafinil
MAOi A and B-inhibitor for parkinsons OR depression (rasagiline/ selegiline/ isocarboxazid/ phenezine/ tranycypromine)
selegiline
MAOi B-inhibitor for parkinsons (rasagiline/ selegiline/ isocarboxazid/ phenezine/ tranycypromine)
rasagiline, selegiline does B and A at high doses
MAOi a-inhibitor for depression (rasagiline/ selegiline/ isocarboxazid/ phenezine/ tranycypromine)
selegiline, isocarboxazid, phenezine, tranycypromine
If someone is on an MAOi they can have low BP or elevated BP due to increased NE, especially if they eat food with _________
tyramine
What are the two COMTi drugs?
- Entacapone 2. Tolcapone
which COMTi can cause liver failure? (Entacapone/ Tolcapone)
Tolcapone
which COMTi can cause nausea and fatigue? (Entacapone/ Tolcapone)
Entacapone
What are the 4 D2 receptor agonists for parkinson’s and restless leg syndrome?
- Bromocriptine 2. Pramipexole 3. Ropinerole 4. Apomorphine
A D3 agonist that is for Schizophrenia but also for depression is (Aripiprazole/ Amantadine)
Aripiprazole
Used to treat parkinson’s and Influenza (Aripiprazole/ Amantadine)
Amantadine
Which DA synapse depleting drug is used for hypertension (reserpine/ tetrabenazine)
reserpine
Which DA synapse depleting drug is used for Huntington’s chorea (reserpine/ tetrabenazine)
tetrabenazine
schizophrenia w/ (+) symptoms, treat w/ D2 blocker, blocking the (mesolimbic/ mesocortical/ nigrostantial/ tuboinfundibular) pathway leads to extrapyramidal symptoms =EPS
nigrostantial
What are the 3 high potency first gen antipsychotics, FGA
- haloperidol 2. fluphenazine 3. thiothixine
What are the 2 low potency first gen antipsychotics, FGA
- chloropromazine 2. thioridazine
this drug is used for refractory schizophrenia, antagonizes D2 and 5HT2a, requires WBC monitoring, it is ________
clozapine
In the parasympathetics of the eye, muscarinic receptors are blocked by (atropine/ d-tubocurarine)
atropine
In the parasympathetics of the eye, nicotinic receptors are blocked by (atropine/ d-tubocurarine)
d-tubocurarine
Name 4 muscarinic agonists that cause pupillary constriction, increase aqueous outflow
- Acetylcholine 2. Carbachol 3. Methacholine 4. Pilocarpine
- Acetylcholine 2. Carbachol 3. Methacholine 4. Pilocarpine cause pupillary (dilation/ constriction)
constriction, muscarinic agonists, parasympathetic
Name 5 muscarinic antagonists that cause pupillary dilation and paralysis of the ciliary body, cycloplegia
- Atropine, longest lasting 2. Scopolamine 3. Homatropine 4. Cyclopentolate 5. Tropicamide, shortest lasting
- Atropine 2. Scopolamine 3. Homatropine 4. Cyclopentolate 5. Tropicamide cause pupillary (dilation/ constriction)
dilation
(parasymp/ symp) stimulation will suppress aqueous humor production(parasymp/ symp) stimulation will increase aqueous outflow
symps suppress productionparasymps -> contract ciliary -> spread trabecular mesh -> increase outflow
Parasympathetic stimulation causes (contraction/ relaxation) of the ciliary muscles
contract ciliary -> spread trabecular mesh -> increase aqueous outflow
Horner’s syndrome, ptosis, myosis, anhydrosis, is a lesion in (symps/ parasymps)
sympathetics
Parasympathetic disfunction leading to large pupil, but no loss of occular movements (Adie’s/ aneurysm compressing ciliary gang)
Adie’s, just some lesion of ciliary gang
Parasympathetic disfunction leading to large pupil, with some loss of occular movements (Adie’s/ aneurysm compressing ciliary gang)
aneurysm compressing ciliary gang
Tension headaches are usually (unilateral/ bilateral) while migraines are usually (unilateral/ bilateral)
tension: bilateral; migraine: unilateral
Which are more aggravated by physical activity (tension/ migraine) headaches
migraine tension headaches don’t prohibit activity
Which is more common in women? (migraine/ tension/ cluster) headache
migraine and tension
Which is more common in men? (migraine/ tension/ cluster) headache
cluster
which is associated with smoking and lionine facies? (migraine/ tension/ cluster) headache
cluster
Which is best treated with O2 therapy? (migraine/ tension/ cluster) headache
cluster
which is the most common type of headache? (migraine/ tension/ cluster) headache
tension, episodic
focal neurological symptoms that precede a headache is called _______
Aura
which type of headache may be preceded by aura? (migraine/ tension/ cluster) headache
migraine with auravs. migraine without aura
migraine med: side effects include nausea, so may be administered IV (Triptans/ ergotamines + DHE)
ergotamines + DHE
migraine med: selective 5HT 1B+D agonist (Triptans/ ergotamines + DHE)
triptans
migraine med: Work well only if administered early (Triptans/ ergotamines + DHE)
triptans
migraine med: side effect of chest pain (Triptans/ ergotamines + DHE)
Triptans and ergotamine + DHE
this headache has a clockwork daily and annual rhythm (migraine/ tension/ cluster) headache
cluster
which is an MAOi for depression?(tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
tranylcypromine, phenelzine
which is used for bi-polar disorder? (tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
lithium salts
find the SSRIs(tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
fluxenetine, citalopram
which are serotinin-norepi reuptake inhibitors, SNRI? (tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
duloxetine, venlafaxine
Which are the “atypicals” that inhibit 5-HT uptake? (tranylcypromine/ imipramine/ amitripyline/lithium/ fluoxetine/ citalopram/ bupropion/ duloxetine/ mirtazapine/ venlafaxine/ phenelzine)
mirtazapine, bupropion
Oxidizes more NE, 5-HT and tyramine (MAOa/ MAOb)
MAOa
If you want to prevent parkinson’s, inhibit more (MAOa/ MAOb)
MAOb, oxidized DA and phenyethamine
Ketamine is a ______ receptor antagonist
NMDA-glutamate
Bupropion has most of it’s effectivity on (NE/ DA/ 5-HT)
DA
glutamate NMDA receptor blocker (Felbamate/ Topiramte)
Felbamate
glutamate AMPA and Kainate receptor blocker (Felbamate/ Topiramte)
topiramate
Which is the “gold standard” for maintenance of general anesthesia? (Isoflurane/ Desflurane/ Sevoflurane)
Isoflurane
Which is the agent of choice for a mask induction b/c it is least smelly? (Isoflurane/ Desflurane/ Sevoflurane)
Sevoflurane sweet-smelling
Which requires a gas blender due to it’s low B.P.? (Isoflurane/ Desflurane/ Sevoflurane)
Desflurane
Which can be nephrotoxic when combined with CO2? (Isoflurane/ Desflurane/ Sevoflurane)
Sevoflurane
Which anesthetic has the unique property of being anti-emetic at low concentrations (Sevoflurane/ methohexital/ Propofol/ Etomidate/ Ketamine)
Propofol
Which anesthetic is a GABAa receptor agonist? (Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Methohexital, Propofol and Etomidate
Which anesthetic causes “dissociative anesthesia”? (Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Ketamine
Which anesthetic stimulates the sympathetic nervous system? (Sevoflurane/ Methohexital/ Propofol/ Etomidate/ Ketamine/ Dexmedetomide)
Ketamine